LYMPHOEPITHELIAL SIALADENITIS (LESA): AN UNCOMMON LESION WITH BENIGN SOLID TUMOR CHARACTERISTICS PRESENTED IN A FIVE-YEAR OLD FEMALE PATIENT. DIAGNOSIS, PROGNOSIS AND TREATMENT.
Authors:
M. Kardara-Bellou, V. Papakosta, A. Balakas, S. Vassiliou
Affiliation:
Department of Oral and Maxillofacial Surgery, Attikon Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
Doi: 10.54936/haoms242p28
ABSTRACT:
Objectives: TLymphoepithelial Sialadenitis (LESA) is a quite rare disease occurring either in the parotid or submandibular gland. The lesions are characterized by lymphocytic infiltration which leads to parenchymal atrophy. It is more common between middle aged women and usually related with autoimmune diseases like Sjogren’s syndrome(SS). Patients infected with Human Immunodeficiency Virus (HIV), specifically children, are prone to such lesions and LESA tends to be an early manifestation of the infection. Predispotision to Non- Hodgkin’s Lymphoma is also mentioned in literature. This study highlights the rarity, the diagnostic complexity of LESA and the prognosis. Moreover it is attempted to demonstrate the therapeutic path provided by our Department.
Materials and Methods: A five year old female patient with a free medical history was presented to the Department of Craniomaxillofacial Surgery complaining for a localised swelling at the front border of the right parotid gland, first presented 10 months ago impairing mouth opening. She was already undergone specific blood exams, Fine-needle Aspiration (FNA), ultrasounds and a MRI. Differential diagnosis included a reactive lymphnode, vascular tumor and autoimmune lymphadenitis. A surgery under general anaesthesia was set. The lesion was excised using a modified Blair’s incision under facial nerve monitoring.
Results: Post surgically, temporary paralysis of right facial nerve brands was not observed. The histopathologic examination of the lesion set the diagnosis of Lymphoepithelial Sialadenitis (LESA). An appointment with the Rheumatology Department was scheduled. During the Follow-up there was not any complications observed. However the patient developed a tumor in the left parotid gland after 5 months and a strict follow-up programme was set. No corticosteroids was given due to patient’s age.
Conclusions: LESA is a salivary gland disease characterised by lymphoepithelial lesions. Differential diagnosis includes systemic diseases like Sjögren’s syndrome, HIV-infection and marginal zone B-cell lymphoma which require further investigation and therapy. An exact diagnosis may be difficult to be obtained. Extraction and histopathologic analysis of the specimen sets the solution to the diagnostic algorithm.
KEY WORDS:
Authors:
M. Kardara-Bellou, V. Papakosta, A. Balakas, S. Vassiliou
Affiliation:
Department of Oral and Maxillofacial Surgery, Attikon Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
Doi: 10.54936/haoms242p28
ABSTRACT:
Objectives: TLymphoepithelial Sialadenitis (LESA) is a quite rare disease occurring either in the parotid or submandibular gland. The lesions are characterized by lymphocytic infiltration which leads to parenchymal atrophy. It is more common between middle aged women and usually related with autoimmune diseases like Sjogren’s syndrome(SS). Patients infected with Human Immunodeficiency Virus (HIV), specifically children, are prone to such lesions and LESA tends to be an early manifestation of the infection. Predispotision to Non- Hodgkin’s Lymphoma is also mentioned in literature. This study highlights the rarity, the diagnostic complexity of LESA and the prognosis. Moreover it is attempted to demonstrate the therapeutic path provided by our Department.
Materials and Methods: A five year old female patient with a free medical history was presented to the Department of Craniomaxillofacial Surgery complaining for a localised swelling at the front border of the right parotid gland, first presented 10 months ago impairing mouth opening. She was already undergone specific blood exams, Fine-needle Aspiration (FNA), ultrasounds and a MRI. Differential diagnosis included a reactive lymphnode, vascular tumor and autoimmune lymphadenitis. A surgery under general anaesthesia was set. The lesion was excised using a modified Blair’s incision under facial nerve monitoring.
Results: Post surgically, temporary paralysis of right facial nerve brands was not observed. The histopathologic examination of the lesion set the diagnosis of Lymphoepithelial Sialadenitis (LESA). An appointment with the Rheumatology Department was scheduled. During the Follow-up there was not any complications observed. However the patient developed a tumor in the left parotid gland after 5 months and a strict follow-up programme was set. No corticosteroids was given due to patient’s age.
Conclusions: LESA is a salivary gland disease characterised by lymphoepithelial lesions. Differential diagnosis includes systemic diseases like Sjögren’s syndrome, HIV-infection and marginal zone B-cell lymphoma which require further investigation and therapy. An exact diagnosis may be difficult to be obtained. Extraction and histopathologic analysis of the specimen sets the solution to the diagnostic algorithm.
KEY WORDS: